"Emotion processing, neuropsychiatric symptoms and quality of life after a stroke".

Abstract:

Cerebrovascular disease is one of the leading causes of death among persons aged 50 and
above and when a stroke does not result in death, it can cause residual cognitive, motor and
behavioural disabilities. Emotional effects of brain injury range from reduced quality of life to
various neuropsychiatric disturbances and are of great interest in the South African context and
throughout the world as they pose a major obstacle to the rehabilitation process. This study
explored the relationship between emotion processing, neuropsychiatric symptoms and quality of
life specifically, how they operate following a cerebrovascular accident. In order to achieve this,
an adult population of high functioning stroke survivors completed the emotion processing scale
(EPS), Minnesota Multiphasic Personality Inventory (MMPI-2) and comprehensive quality of
life inventory (ComQOL-A5) and a factor analysis provided statistical evidence suggestive of
intercorrelations among the variables. The results lent support to this theoretical relationship and
determined the structure of this relationship as follows: The satisfaction with quality of life after
a stroke that relates to traditional masculine or feminine roles, when not fulfilled, related to
neuropsychiatric symptoms of general maladjustment i.e. schizophrenia and psychopathic
deviate. The second factor encompassed symptoms of general anxiety both internally and
externally directed: Internally directed anxiety included symptoms of hypochondriasis and
hysterical conversion, while externally directed anxiety included neuropsychiatric symptoms of
paranoia. The third factor was associated with mood modulation in that elevated mood connected
to neuropsychiatric symptoms of hypomania and depressed mood connected to symptoms of
depression and social introversion. Finally, emotion processing and psychasthenia made up the
last principal component, namely emotion modulation. This meant that avoidance of emotional
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content, suppression of emotion, unprocessed emotion etc. related to neuropsychiatric symptoms
of obsessions or compulsions. High functioning stroke survivors’ behaviours were thus
characterised by general maladjustment, anxiety, and symptoms related to mood and emotion
modulation. This study underlies the importance of diagnosing, treating and monitoring stroke
survivors’ emotional alterations and suggests the usefulness of its application in clinical settings
to evaluate the effectiveness of treatments or more general interventions to improve the
neuropsychiatric sequelae and quality of life of stroke survivors. Improved understanding of
these constructs from the stroke survivor’s perspective has obvious impact for the therapeutic
interventions inherent in stroke rehabilitation and as such, contributes towards the fields of
neuropsychology, neuropsychotherapy and the social sciences.